Healthcare Provider Details

I. General information

NPI: 1881134666
Provider Name (Legal Business Name): ASHLEY OPHELIA DURKEE HESTER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2017
Last Update Date: 04/19/2022
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 LAKE BOONE TRL STE 200
RALEIGH NC
27607-7507
US

IV. Provider business mailing address

4301 LAKE BOONE TRL STE 200
RALEIGH NC
27607-7507
US

V. Phone/Fax

Practice location:
  • Phone: 919-445-5792
  • Fax: 919-445-5799
Mailing address:
  • Phone: 919-445-5792
  • Fax: 919-575-1282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4184
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number4184
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: